Archive for October, 2012

Howard and Sykes: Medicaid Is Broken—Let the States Fix It

Block-granting Medicaid is the best way to deliver better, cost-effective care to the most vulnerable Americans.


Medicaid, America’s safety-net program for more than 62 million low-income uninsured Americans, is broken. It’s broken at the state level, where program costs are swamping state budgets. It’s broken for federal taxpayers, as Medicaid waste, fraud and abuse drain tens of billions of dollars from federal coffers every year. And, most important, it’s broken for the millions of families who can’t find doctors willing to accept Medicaid’s rock-bottom reimbursements.

Fixing the Medicaid safety net must be a priority of the next administration and Congress.

The best hope for Medicaid reforms that can improve care for low-income enrollees, reduce fraud, and put the program on a sustainable trajectory is to cap federal spending to the states by using block grants. Block grants would offer states a predictable source of federal funding in return for broad state flexibility in Medicaid administration, benefits and copays.

Read more here. (WSJ subscription required)


Mr. Howard is the director of the Manhattan Institute’s Center for Medical Progress and author of the new report, “How Block Grants Can Make Medicaid Work.”  Mr. Sykes is a senior fellow at the Empire Center for New York State Policy.


The State of Play in National Politics and Why Nothing is Getting Done in Washington

Now that the national political conventions are comfortably behind us, the presidential debates have begun and the race is in full and final swing; let me point out the obvious:

Politics and Policy no longer mix.

Any casual observer of the Democratic Convention or the Republican Convention would (or should) come to that conclusion. Similarly, the first presidential debate and the candidates’ stump speeches prove this point.

National Public Radio (NPR) produced a very interesting story last week that compared the President’s economic speech to Romney’s. Both men boast five-point plans to revive our economy and amazingly, the first four points are identical. Yes, you read that correctly. Their prescriptions for our economic ills are the same.

Point #1: Increase U.S. exports.
Point #2: Give our country energy independence.
Point #3: Provide more Americans with job skills to compete in today’s world economy.
Point #4: Reduce the federal budget deficit and the corresponding debt.

Don’t believe me? Click here and listen to the words from the candidates themselves. (The fifth point is where they differ in priorities with Romney discussing small business development and the President focusing on national security.)

Any reasonable person would say each of these points is a laudable goal; the problem lies in how to get there. The political right and the political left have very different views on how to achieve these economic goals and they box in their candidates with political advertising designed to incite their respective electoral bases toward all-or-nothing viewpoints.

In other words, men and women of different parties are no longer allowed to work with each other in an effort to solve problems. If smart people from either party (I guess dumb people for that matter) try to solve these big problems, then the political powers that be take over the reins, robbing Americans of much needed leadership, responsibility, and accountability.

Before you start bashing me for being soft on beliefs or ideals, let me be clear – what one stands for says a lot about whom that person is – and that includes core political beliefs. Those beliefs are certainly important to both the political and policy process.

I happen to be a registered Republican with a core set of policy views: that the government’s central role is to provide for the common defense, protect our homeland, and build and maintain our domestic infrastructure.

Perhaps the most important point in that statement is that I said, “central role” not “only role”. There are certainly other responsibilities best handled by government so long as those responsibilities don’t become impediments to a free society. This column isn’t meant to debate what those other responsibilities might be – health care, education and environment as examples. Instead, the point being made here is that politics at the national level is getting in the way of legitimate policy debates and more importantly, legitimate policy solutions.

For example, we had a chance last year to come together and start working on debt and deficit reduction. Six Democrats and six Republicans – staffed by some very smart people – were given full power and authority to design a deficit and debt reduction plan that would be agreed to by both parties. Instead they punted into “sequestration” because they were too scared to make tough choices for fear of political losses. As a result, the American public lost again.

Public service is supposed to mean serving the public, not one’s political career. I know one person who staffed that debt commission, and he was so frustrated and distraught that the members in the room wouldn’t work together that he quit after nearly 20 years on Capitol Hill. He was a public servant making 25 percent of what he could have been making in the private sector, and after all those years he came to the conclusion that solving the big problems had succumbed to politics. So he left Capitol Hill, and best of all, he didn’t leave to become a lobbyist. He left to become an accountant.

This experience illustrates the arrogance of the political left and political right who seem to believe that their solution is the only solution and the only possible course of action. In my view, that notion is absurd. No one has all the right answers.

There are three reasons why this has happened: 1) Congressional redistricting, 2) Super PACs, and 3) and the 24-hour news cycle coupled with the advent of social media.

1) Redistricting wars over the past 30 years have enabled politics to take center stage and push policy to the sideline. Charlie Cook, a non-partisan political analyst, who also happens to be from Louisiana, created the Partisan Voting Index (PVI) in 1997 for his Cook Political Report, to better assess the competitiveness of each of the 435 congressional districts. Based on this index, in the 1990s there were 134 seats that were essentially safe for Democrats and 142 that were essentially safe for Republicans. That left 159 seats up for grabs.

Today, there are 149 safe Democratic seats and 182 safe Republican seats leaving only 104 to be contested, or about 24 percent of the House of Representatives. In other words, by redrawing the lines and insuring one party or the other will automatically win the seat, then that seat becomes more and more conservative for the Republicans and more and more liberal for the Democrats. The number in the middle keeps shrinking and thus so does the willingness of members of Congress to work together to solve the policy problems of the nation.

2) In 2010, the U.S. Supreme Court ruled in Citizens United v. Federal Election Commission that the First Amendment prohibited the government from restricting independent political expenditures by corporations and unions. The not-for-profit group Citizens United brought the suit because it wanted to purchase and broadcast advertisements about a film critical of Hillary Clinton, who was running for President. These ads were in apparent violation of the 2002 Bipartisan Campaign Reform Act (commonly known as the McCain–Feingold Act). In a 5–4 decision, the Court held that portions of McCain-Feingold’s Section 203 violated the First Amendment.

That ruling, along with a decision by the U.S. Court of Appeals for the District of Columbia in v. Federal Election Commission, paved the way for the creation of Super PACs. These PACs may accept contributions of any size from corporations, unions, or individuals as long as the organization makes only independent expenditures in support of or opposition to a candidate, and does not make contributions to candidates. The Citizens United decision also allowed incorporated 501(c)(4) public advocacy groups and trade associations to make expenditures in political races. The 501(c)4′s may not have a primary purpose of engaging in electoral advocacy and have to disclose their expenditures, but unlike super PACs, they do not have to include the names of their donors in their FEC filings.

These court decisions have established an environment where sensationalism and fact twisting can be driven into every home in America with little or no consequence. The national parties and Super PAC third party groups provide cover and/or ammunition for party politicians and therefore the elected officials become beholden to those partisan viewpoints even if they know those views won’t get things done in DC.

3) The 24-hour news cycle forces journalists of all political persuasions to often run with half-baked, sensationalist stories in order to fill broadcast time and keep viewers engaged. This approach enables any person with a computer, smart phone or tablet to take the story “viral”, regardless of its veracity or sourcing. Political organizations like the Super PACs discussed earlier can use this 24-hour tool to fire up their bases and move the political needle without regard for the policy consequences. Using only 140 characters to distill complicated debates into sound bites or 30 second snippets obfuscates the importance and details of policy discussions and the resulting solutions that must come from those debates. We are inundated with snapshots of the news rather than full and substantial information. These snapshots have caused misinformation and partial information to be presented to the public, leaving people scratching their heads and pointing fingers at one another.

In Louisiana, other than the obvious need to be engaged in national policy debates, we should also be concerned that this national political disease will infect our state and local debates, turning once thoughtful discussions into partisan rhetoric that give us no true path forward toward prosperity.

This mindset is slowly seeping into today’s Louisiana as Governor Jindal proposes reform while legislators on both sides of the aisle – with help from journalists and longstanding political power players – push back.

I’m not suggesting the Governor should be made emperor because as I said earlier, no one has a monopoly on all the best ideas.  However, it is frustrating to say the least, that after decades of sitting at the bottom of all the national lists in areas like education and healthcare, we still have people with big bullhorns who are playing politics in an effort to keep their noses in the trough.  Instead, they should be working together, offering constructive solutions to help solve the policy problems of our day.

Big Bird is a Menace to Our Economy

Check out the latest Barack Obama campaign ad.  (I can’t help it.  This is HILARIOUS!)

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Grover Nordquist Holds Firm on Tax Debate

From Politico

WILL CEO PUSH HELP? — “CEOs pushed for a big deal during the debt ceiling debate, but were disappointed when Congress punted. The two parties are still deeply entrenched — and will be regardless of who takes the White House in November. Plus, bankers don’t carry the same clout as they once did. … Even the executives believe the best they can do is offer Republicans cover from backlash from tea party supporters and anti-tax advocates if they sign on to anything that includes increased revenue. …

“‘There is certainly a tea party caucus that still has a strong aversion to anything involving taxes, but what CEOs are saying is they are ready to get behind a comprehensive solution in which everything is in play,’ said John Engler, the former Republican governor of Michigan and head of the Business Roundtable, which represents CEOs of U.S. companies with $7.3 trillion in annual revenues. ‘It has to be a real solution, not a faux fix with promises to do things later. If it’s real, then executives will get behind it.’”

NORQUIST STILL SAYS NO – “These corporate efforts are not going to magically make conservative opposition to significant new revenues disappear. House Speaker John Boehner has said he is opposed to any overall in increase in taxes. And zealous opponents of new revenues are not planning to stand down. ‘The Paul Ryan plan brings the budget into balance, is not a net tax increase and reduces spending as a part of GDP and pays off the national debt as you go out the door,’ Americans for Tax Reform’s Grover Norquist said. ‘This idea that you have to trade entitlement reform for a tax increase is put forward by Democrats who, when they had power, didn’t do entitlement reform and don’t want to do entitlement reform. Democrats just want GOP fingerprints on a tax increase.’”

Richard McGregor, Financial Times Washington bureau chief, profiles Romney in “Born to run?”

“Romney has helped mightily in dismantling his own life story. Instead of the election being a referendum on Obama’s economy, the combination of Romney’s serial missteps and the brutally targeted Obama campaign have made the poll much more of a vote on the Republican candidate. … If the Obama campaign wanted to invent a caricature of an out-of-touch plutocrat, they could not have done a better job than their opponent did himself [with the 47% tape]. … Like John Kennedy, the first Catholic to be elected president, Romney is a trailblazer for the Mormon religion, long considered an outlier among religions in the US. His ambition also has a whiff of the psychodrama of George W. Bush’s efforts to restore the family honour after his father was defeated after a single term in office. …

“Many people who know him, or who worked with him in Massachusetts, yearn for the real Romney to reappear. Douglas Foy was one of many outsiders appointed by Romney to executive positions in Massachusetts. A lawyer who had established and run an environmental advocacy group for a quarter of a century, Foy’s appointment to head a superagency overseeing transport, energy and the environment irritated sections of the business community. Foy remembers Romney as practical and straight and not as the stiff buttoned-up figure that many see today. ‘I never understood why they had him walled off,’ he says. …

“If Romney does lose the election, the turning point might be his [mid-June] departure on his six-state bus tour from the New Hampshire farmhouse. While Romney was holding small rallies, generating positive local news coverage, the Obama machine cranked up a campaign of negative attacks costing tens of millions of dollars. Obama’s air war was devastating. The portrait of Romney as a latter-day robber baron raiding companies and laying off workers at Bain Capital angered many business leaders. But it hit home with its target audience, the middle classes of middle America, in states such as Ohio, Iowa and Wisconsin. For many political professionals, Romney’s fatal mistake was not to have advertisements up at the same time, telling his own life story on his own terms.”

Read the full story here.


Mike Allen @ Politico — Romney Rebound?

“After weeks of taking a beating in the media and from Republicans, Mitt Romney is finally catching some breaks, and is poised for a surge in more positive coverage IF he exceeds expectations tonight. A number of things broke his way in the past 24 hours. None of them, alone, suggests anything profound. But in totality, they offer Republicans reason for hope coming out of tonight:

1) The Biden gaffe referring to ‘a middle class that has been buried the last four years.’ Voters seem aware of who was in charge during those years.

2) The 2007 videotape of then-Senator Obama that surfaced last night and rocketed through right-wing media. The N.Y. Times and WashPost ignored it on their homepages this morning, but conservatives will force the MSM and voters to reckon with it. No doubt, some of the quotes could be used against President Obama.

3) A new NBC-WSJ-Marist poll shows Virginia and Florida tightening, and there is evidence that Romney efforts to target Hispanics in swing states is blunting Obama’s edge.

4) It all comes down to tonight. If Romney rocks, he will put concerns about message and his campaign team to rest for a few days — and put tougher attention back on Obama.”

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